Say You’re Hurt Here, Say You Flag Down An Ambulance

Here’s what to expect. Hint: it isn’t pretty

BY: BILL FOLDES

So how is it decided what hospital you are taken to in an emergency? That depends on where the hospitals are located and what type of injury or illness the patient has. In areas where there are multiple hospitals very close together, as in Los Cabos, it should be the patient’s choice. Some hospitals run ambulances, in which case, as you would expect, those ambulances will transport to their hospital. However, in all cases, a patient must be transported to a hospital with appropriate treatment for their injury.

Some hospitals are specialty centers. If a patient needs these resources, the patient should be transported to the nearest hospital that has them. In the case of a vehicle accident, if significant trauma is suspected, the ambulance should transport the patient to the nearest trauma center unless the patient’s life is in danger, in which case the ambulance should go to the nearest hospital first to treat this, then move the patient to the appropriate specialty center.

These are a lot of “shoulds”. Usually in Los Cabos those shoulds are ignored and it often comes down to a physical struggle or a crap shoot where you end up. Or, it’s decided by extraordinary marketing.

We have too many hospitals here, and even too many doctors. That creates an unseemly battle for injured and sick but still breathing bodies. Most hospitals have their own ambulances to feed these people into their hospital. St Lukes, a small hospital in San Jose, has no less than seven ambulances for their two facilities. Their spokesman, tells us their policy is to take a patient suffering a life threatening condition to the nearest hospital that has emergency services. “If the condition is not life threatening the patient should be able to choose which hospital where they will be taken. When the patient is taken to the nearest hospital with emergency facilities, the hospital is required to offer free ‘stabilization of patient’ services up to 24 hours, before sending the patient to another hospital.”

But of course that never happens, and it’s not just this hospital that gets aggressive in procuring patients, they all do. And a free 24 hour stay? Never happens.

The ambulance drivers monitor the police bands and when there’s an emergency of any kind they zoom to the scene in hopes of picking up a patient or two. It’s not uncommon for five ambulances to show up at a minor fender bender and even get into fist fights for transporting privileges. And of course no ambulance driver is going to keep his job if he delivers a patient to a competing hospital.

We’re talking about foreigners getting into trouble. Let a poor Mexican get into an accident or suffer a stroke and they can damn well wait for the Red Cross ambulance, and pray they have gasoline in the tank. And, they can pretty much kiss their wallet and shoes good-bye, because those will likely be harvested along the way.

Marketing to foreigners iis intense, with most of the hospitals employing full time body snatchers. Well, that may not be their official job title, but that’s the job description. One of their tactics is to call on police, concierges, and guards who work at foreign-heavy developments, and offer a reward for steering Gringos to their hospital. Many of them even pass out stickers with their hospital’s number on it, expecting that point person to put the sticker on the back of his cell phone, the better to remember who to call to get an ambulance and collect their reward.

Last month a San Diego woman who was staying at a private home out in Puerto Los Cabos, way the other side of San Jose, had a stroke. The host called his guard shack at the entrance to the complex, and the guard called the sticker on the back of his phone. But that hospital did not have the facilities to handle a stroke victim, so the husband, who happened to be a doctor in La Jolla California, got into an argument with the ambulance driver, demanding that she be taken to the new hospital, H+. (Yeah, stupid name for a hospital).

The driver refused, threatening to just leave her there lying on the ground. Another ambulance was called, and it turned out it was a good decision, because the woman needed two brain surgeries within the first two days. H+ flew a neurosurgeon over from their sister hospital on the mainland, who stayed for three days until they were confident they had stopped the bleeding in the brain. There is no other hospital in Los Cabos that could have come near that level of care. The cost? Insurance paid for all but the charter jet to get the surgeon here.

So, pick your ambulance carefully, because that may ultimately determine your care - and your life.